Medicare Part B (Medical Insurance) doesn’t cover these:
- Insulin (unless use of an insulin pump is medically necessary
- Insulin pens
- Alcohol swabs
Part D covers these:
- Injectable insulin that isn’t used with a traditional insulin pump
- Insulin used with a disposable insulin pump
- Certain medical supplies used to inject insulin, like syringes, gauze, and alcohol swabs
Your costs in Original Medicare
The cost of a one-month supply of each Part D-covered insulin is capped at $35, and you don’t have to pay a deductible for insulin. This applies to everyone who takes insulin, even if you get Extra Help. If you get a 60- or 90-day supply of insulin, your costs can't be more than $35 for each month's supply of each covered insulin. For example, if you get a 60-day supply of a Part D-covered insulin, you'll generally pay no more than $70. Other questions about insulin coverage?
If you take insulin, you should get help comparing Medicare drug plans and costs for 2023:
- Call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
- Contact your local State Health Insurance Assistance Program (SHIP) to get free personalized health insurance counseling.
Note: Starting July 1, 2023 similar caps on costs will apply for insulin used in traditional insulin pumps (covered under Medicare Part B).
For insulin used with a traditional insulin pump that's covered under the Medicare durable medical equipment benefit, you pay 20% of the Medicare-Approved Amount after you meet the Part B deductible. You pay 100% for insulin-related supplies (like syringes, needles, alcohol swabs, and gauze), unless you have Part D.
Things to know
If you use an external insulin pump that isn’t disposable, Part B may cover insulin used with the pump and cover the pump itself as durable medical equipment (DME). If you live in certain areas of the country, you may have to use specific insulin pump suppliers for Medicare to pay for a durable insulin pump.